National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024

Submission 192

deeply concerned about the proposed changes to the Act and the Rule-making powers. These changes could lead to negative outcomes. The Minister claims these changes will address issues like “auto-tops” and claims for items such as cryptocurrency or drugs. However, responsible participants are already aware that such claims are not permitted under the current legislation and guidelines. Proper initial plan funding, education, support, and monitoring by the NDIA can prevent these issues from occurring without requiring changes to the legislation.

I am also worried that these changes will lead to stressful assessments by unknown assessors with unspecified experience. These untested assessments may not be fit for the wide spectrum of complex disabilities, potentially focusing on primary and secondary diagnoses rather than providing individual, reasonable, and necessary supports. This could result in inappropriate funding, participants left with no access to funding due to NDIA delays of funding is released in instalments, difficulties appealing insufficient plans, and a lack of flexibility due to fixed lists of what can and cannot be funded. Major recommendations from the NDIS review and other inquiries are being ignored, and I urge you to review the concerns raised in the ME/CFS & NDIS group submission, which covered some of these topics.

I would like to address the proposed amendment to the bill regarding the assessment of the whole person without necessarily finding the supports they need. This approach does not resolve the issue that the whole person requires support, rather than just the parts selected by the NDIA. Disability is complex; the whole is greater than the sum of its parts, and it is not just a person’s impairments but also the environment that results in disability. Isolating the impacts of each impairment is not practical and will likely lead to poor outcomes.

For individuals with complex disabilities like mine, which involve multiple impairments under one diagnosis, proving each impairment is permanent and fully treated while securing the necessary support in a timely manner will be burdensome. The NDIS is impairment-based, not diagnosis-based, so the permanence of my diagnosis will not cover support for new impairments that may arise as my condition progresses. I do not have the energy or resources to constantly obtain medical reports or undergo access reassessments. People with more complex disabilities will face significant challenges under this change.

If this amendment proceeds, it must be legislated that:

• A clear statement on which impairments are approved be provided upon access,
• A separate section of the Act must cover requests to add an impairment, who determines the and a time frame for a decision,
• A reviewable decision process must be included for both of these.

The current proposal to assess and support only impairments at the time of the needs assessment is inadequate. It fails to specify who determines these impairments and risks leaving participants in a continuous loop of appeals and reviews.

I am also concerned that the legislation still permits the creation of “classes” of participants and supports based on these classes. Additionally, the government’s suggestion in the explanation of the multiple impairments amendment that if a person meets access criteria in one domain, but their disability may affect another domain (e.g., diabetes management), they may assess in the other domain. This suggests that the NDIA will determine which domains we will be assessed for supports in, potentially limiting supports to only those domains where a person meets a substantially reduced functional capacity criterion. This approach narrows the supports a person may be eligible for, ignoring that one impairment can impact multiple domains even if it does not cause substantial functional impairment in every domain. Substantially reduced functional capacity and disability supports should be assessed holistically rather than on a domain-by-domain basis.

National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024

Submission 192

The current NDIA practice of requiring additional impairments to meet full access criteria on their own is already problematic. If additional impairments are to be supported only if they meet access criteria, these criteria must be clearly defined for subsequent impairments post-access, and a reviewable decision process must be in place.

If meeting access criteria is required, the only access criterion for additional impairments should be permanence, as substantially reduced function and other criteria have already been established under s24. This should be specified clearly to avoid misunderstandings of s24.

I am also concerned that rules about what can and cannot be purchased might be rushed through as temporary measures. If these rules are to be changed, they should be done correctly from the start to avoid confusion. Ideally, we should stick with the current rules and Act, which allow for supports that are reasonable and necessary and enable participants to spend in accordance with their plans.

The changes concerning debts are also problematic. Instead, I encourage an amendment that allows participants to appeal a decision to refuse to pay a claim, as there is currently no such appeal process. This situation leaves participants in debt to providers rather than the government, which is riskier for the participants.

Thank you for considering my concerns.